scholarly journals Evaluating the Medical Malpractice System and Options for Reform

2011 ◽  
Vol 25 (2) ◽  
pp. 93-110 ◽  
Author(s):  
Daniel P Kessler
Keyword(s):  
Medical Malpractice ◽  
Healthcare Providers ◽  
Healthcare Spending ◽  
The United States ◽  
Defensive Medicine ◽  
Cost Of Health Care ◽  
Malpractice Law ◽  
Patient Health ◽  
Malpractice Liability ◽  
The U.S

The U.S. medical malpractice liability system has two principal objectives: to compensate patients who are injured through the negligence of healthcare providers and to deter providers from practicing negligently. In practice, however, the system is slow and costly to administer. It both fails to compensate patients who have suffered from bad medical care and compensates those who haven't. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability—to practice “defensive medicine.” The failures of the liability system and the high cost of health care in the United States have led to an important debate over tort policy. How well does malpractice law achieve its intended goals? How large of a problem is defensive medicine and can reforms to malpractice law reduce its impact on healthcare spending? The flaws of the existing system have led a number of states to change their laws in a way that would reduce malpractice liability—to adopt “tort reforms.” Evidence from several studies suggests that wisely chosen reforms have the potential to reduce healthcare spending significantly with no adverse impact on patient health outcomes.

Nursing and Midwifery Malpractice in Turkey Based on the Higher Health Council Records

2004 ◽  
Vol 11 (5) ◽  
pp. 489-499 ◽  
Author(s):  
Ümit N Gündoğmuş ◽  
Erdem Özkara ◽  
Samiye Mete
Keyword(s):  
Health Professionals ◽  
Medical Malpractice ◽  
Civil Law ◽  
Nurse Education ◽  
Health Council ◽  
Malpractice Law ◽  
The World ◽  
Malpractice Liability ◽  
The Media ◽  
Nurses And Midwives

Medical malpractice has attracted the attention of people and the media all over the world. In Turkey, malpractice cases are tried according to both criminal and civil law. Nurses and midwives in Turkey fulfill important duties in the distribution of health services. The aim of this study was to reveal the legal procedures followed in malpractice allegations and malpractice lawsuits in which nurses and midwives were named as defendants. We reviewed 59 nursing and midwifery lawsuits reported to the Higher Health Council between 1993 and 1998. Health professionals were held liable in 59% of the lawsuits. Midwives had the highest percentage of malpractice liability (52%), followed by physicians (29%) and nurses (19%). To reduce potential liability, nurse education should be improved, a nursing malpractice law should be enacted, and instructions for nursing procedures should be formulated.

scholarly journals The changing landscape of military medical malpractice: from the Feres Doctrine to present

2020 ◽  
Vol 49 (5) ◽  
pp. E7
Author(s):  
Callum D. Dewar ◽  
Jason H. Boulter ◽  
Brian P. Curry ◽  
Dana M. Bowers ◽  
Randy S. Bell
Keyword(s):  
Medical Malpractice ◽  
Healthcare Providers ◽  
Supreme Court Decision ◽  
The United States ◽  
United States Government ◽  
National Defense ◽  
Military Healthcare ◽  
Active Duty Personnel ◽  
The Military ◽  
First Time

Medical malpractice suits within the military have historically been limited by the Feres Doctrine, a legal precedent arising from a Supreme Court decision in 1950, which stated that active-duty personnel cannot bring suit for malpractice against either the United States government or military healthcare providers. This precedent has increasingly become a focus of discussion and reform as multiple cases claiming malpractice have been dismissed. Recently, however, the National Defense Authorization Act of 2020 initiated the first change to this precedent by creating an administrative body with the sole purpose of evaluating and settling claims of medical malpractice within the military’s $50 billion healthcare system. This article seeks to present the legal history related to military malpractice and the Feres Doctrine as well as discuss the potential future implications that may arise as the Feres Doctrine is modified for the first time in 70 years.

Abstract 18: Impact of Malpractice Damage Caps on Cardiac Stress Testing and Medicare Spending

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Steven A Farmer ◽  
Ali Moghtaderi ◽  
Nicole E Hovey ◽  
Bernard S Black
Keyword(s):  
Medical Malpractice ◽  
Fixed Effects ◽  
Stress Testing ◽  
Healthcare Spending ◽  
Third Wave ◽  
Level Data ◽  
Before And After ◽  
Malpractice Liability ◽  
Cardiac Testing ◽  
Medicare Spending

Objective: Physicians report that they often order tests to reduce medical malpractice liability risk. We test the hypothesis that caps on non-economic damages (the most stringent commonly adopted reform) will decrease cardiac testing rates, or healthcare spending more generally, using patient-level data for the Medicare population. Methods: We fit a difference-in-differences model on a 5% random sample of Medicare claims between 1999 and 2012. Treatment states (n=9) were those that introduced damage caps during the “third wave” of medical malpractice reform between 2002 and 2005. The remaining states were controls. We compared rates of cardiovascular stress testing and overall spending per enrollee before and after damage caps were adopted. Our model incorporates extensive covariates: individual and zip-code fixed effects; calendar quarter dummies; patient age; the 17 elements of the Charlson comorbidity index, and county-level demographic, socioeconomic, and health care characteristics. Results: Damage caps did not significantly affect total Medicare spending per enrollee (coefficient +0.31%, 95% confidence interval [CI] [-0.44%, 1.06%]); part A (Inpatient) spending (coefficient +0.79%, 95% CI [-0.05%, 1.64%]) or part B (Outpatient) spending (coefficient +0.02%, 95% CI [-0.64%, 0.67%]). Damage caps predict a statistically significant but clinically modest rise in stress testing rates (annual increase = 0.31%, 95% CI [0.04%, 0.58 %]). This is a 2.5% increase in the likelihood that an individual will receive a cardiac test in a given year. Conclusions: We find no evidence that introduction of damage caps in 9 states in the 2000s decreased either cardiac testing or overall healthcare spending when compared with states without these reforms. Indeed, we find a modest increase in cardiac testing rates, and point estimates for overall spending are also positive. We thus provide evidence against the hypothesis that damage caps reduce overtesting or overall spending.

scholarly journals The Impact of COVID-19 on Telemedicine Utilization Across Multiple Service Lines in the United States

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 380 ◽  
Author(s):  
Jose A. Betancourt ◽  
Matthew A. Rosenberg ◽  
Ashley Zevallos ◽  
Jon R. Brown ◽  
Michael Mileski
Keyword(s):  
Risk Mitigation ◽  
Healthcare Providers ◽  
The United States ◽  
Rapid Expansion ◽  
Treatment Modalities ◽  
Compliance Cost ◽  
Safety Standards ◽  
Meta Analyses ◽  
The Impact ◽  
The U.S

The impact of COVID-19 on the U.S. healthcare industry cannot be overstated. Telemedicine utilization increased overnight as all healthcare providers rushed to implement this delivery model to ensure accessibility and continuity of patient care. Our research objective was to determine measures that were implemented to accommodate community and individual patient needs to afford access to critical services and to maintain safety standards. We analyzed literature since 2016 from two databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We compared observations, themes, service lines addressed, issues identified, and interventions requiring in-person care. From 44 articles published, we identified ten effectiveness themes overall and drew conclusions on service line successes. COVID-19 has caused rapid expansion in telemedicine. Necessary and required changes in access, risk mitigation, the need for social distancing, compliance, cost, and patient satisfaction are a few of the driving factors. This review showcased the healthcare industry’s ability to rapidly acclimate and change despite the pervasive spread of COVID-19 throughout the U.S. Although imperfect, unique responses were developed within telemedicine platforms to mitigate disruptions broadly and effectively in care and treatment modalities.

scholarly journals New Rules on Patient’s Safety and Professional Liability for the Italian Health Service

2019 ◽  
Vol 20 (8) ◽  
pp. 615-624 ◽  
Author(s):  
Sara Albolino ◽  
Tommaso Bellandi ◽  
Simone Cappelletti ◽  
Marco Di Paolo ◽  
Vittorio Fineschi ◽  
...  
Keyword(s):  
Medical Malpractice ◽  
Healthcare Providers ◽  
Medical Liability ◽  
Healthcare Economics ◽  
Good Medical Practice ◽  
Legal Literature ◽  
Single Text ◽  
Malpractice Liability ◽  
Legislative Activity ◽  
The Law

Background:The phenomenon of clinical negligence claims has rapidly spread to United States, Canada and Europe assuming the dimensions and the severity of a pandemia. Consequently, the issues related to medical malpractice need to be studied from a transnational perspective since they raise similar problems in different legal systems.Methods:Over the last two decades, medical liability has become a prominent issue in healthcare policy and a major concern for healthcare economics in Italy. The failures of the liability system and the high cost of healthcare have led to considerable legislative activity concerning medical malpractice liability, and a law was enacted in 2012 (Law no. 189/2012), known as the “Balduzzi Law”.Results:The law tackles the mounting concern over litigation related to medical malpractice and calls for Italian physicians to follow guidelines. Briefly, the law provided for the decriminalisation of simple negligence of a physician on condition that he/she followed the guidelines and “good medical practice” while carrying out his/her duties, whilst the obligation for compensation, as defined by the Italian Civil Code, remained. Judges had to consider that the physician followed the provisions of the guidelines but nevertheless caused injury to the patient.Conclusion:However, since the emission of the law, thorny questions remain which have attracted renewed interest and criticism both in the Italian courts and legal literature. Since then, several bills have been presented on the topic and these have been merged into a single text entitled “Regulations for healthcare and patient safety and for the professional responsibility of healthcare providers”.

Barriers To Sexual And Reproductive Care Among Cisgender, Heterosexual And LGBTQIA+ Adolescents In The Border Region: Provider And Adolescent Perspectives.

2021 ◽  
Author(s):  
Randolph D. Hubach ◽  
Rebecca Zipfel ◽  
Fatima A Muñoz ◽  
Ilana Brongiel ◽  
Annabella Narvarte ◽  
...  
Keyword(s):  
Unintended Pregnancy ◽  
Legal Status ◽  
Healthcare Providers ◽  
The United States ◽  
Mobile App ◽  
Border Region ◽  
Social Challenges ◽  
Minority Adolescents ◽  
Mexico Border ◽  
The U.S

Abstract Introduction: The United States (U.S.) has higher rates of sexually transmitted infections (STIs) and adolescent pregnancy than most other industrialized countries. Furthermore, health disparities persist among racial and ethnic minority adolescents (e.g., African American and Latinx) and in counties located along the U.S.–Mexico border region – they demonstrate the highest rates of STIs and unintended pregnancy among adolescents.Methods: Qualitative data were collected as part of formative research for the development of a mobile app that provides gender-inclusive sexual education to adolescents living in the U.S. – Mexico border region. From August 2019 to March 2020, in-depth interviews and focus groups were conducted with healthcare providers (n=11) and cisgender, heterosexual, and SGM adolescents ages 15-18 (n=3; 20 participants).Results: Providers and adolescents reported similar barriers to accessing SRH in this region such as transportation, lack of insurance and cost of services or accessing services without their parent’s knowledge. However, providers shared that some adolescents in this region face extreme poverty, family separation (i.e., parent has been deported), have a mixed family legal status or are binational and have to travel every day from Mexico to the U.S. for school. These challenges further limit their ability to access SRH.Conclusions: Adolescents in the U.S.-Mexico border region face unique economic and social challenges that further limit their access to SRH care, making them uniquely vulnerable to STIs and unintended pregnancy. Our findings provide further evidence for the need for interventions and service delivery, programs tailored for residents in the border region.

Het medisch aansprakelijkheidssysteem en defensief gedrag in België

2021 ◽  
Author(s):  
K. DANIELS ◽  
T. VANDERSTEEGEN ◽  
W. MARNEFFE ◽  
L. DE WILDE
Keyword(s):  
Health Care Providers ◽  
Healthcare Providers ◽  
Defensive Medicine ◽  
The Other ◽  
Medical Liability ◽  
Care Providers ◽  
Defensive Behaviour ◽  
Risk Patients ◽  
Malpractice Liability ◽  
The One

The medical liability system and defensive behaviour in Belgium The aim of the medical liability system is, on the one hand, providing adequate compensation to victims of medical incidents and, on the other hand, incentivising health care providers to adopt sufficient care. However, the fear of healthcare providers for being involved in a liability procedure in case of a medical incident may cause them to practice defensive medicine. Defensive medicine is defined as the ordering of more tests, procedures and visits (assurance behaviour) or the avoidance of high-risk patients or procedures (avoidance behaviour), primarily (but not necessarily solely) to reduce the exposure to malpractice liability. Although various foreign studies assess the prevalence of defensive medicine, it is not yet sufficiently clear to what extent Belgian physicians act defensively in practice. A survey conducted in 2015 among 90 specialist physicians indicates that the medical liability system in Belgium may have an influence on their clinical practice and decision-making. However, additional research is necessary to inform policymakers about the real prevalence of defensive behaviour and its potential drivers and consequences.

Introduction to Regulation of Professionals and Facilities

2020 ◽  
Author(s):  
Deirdre Madden ◽  
Isaac D. Buck
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
The United States ◽  
The European Union ◽  
Regulatory Structure ◽  
Quality Regulation ◽  
Practice Of Medicine ◽  
Different Types ◽  
Patient Health ◽  
National Systems

This chapter briefly introduces the regulation of healthcare providers and facilities within the United States and Europe. It shows that even though the regimes differ in key areas, systems in the European Union and the United States share certain overlapping themes. Quality regulation in both systems seeks to prevent harm to patient health from occurring in the first place. Both European and American systems also face challenges posed by definitional limitations around the practice of medicine, and both employ different types of regulation (and softer incentives) in different scenarios. Nonetheless, the systems also differ in key ways. Most prominently, the American system has a more comprehensive and robust regulatory structure for hospitals and entities than some European systems, although there is wide divergence between national systems in Europe.

Why Patients Sue Doctors: The Japanese Experience

2009 ◽  
Vol 37 (4) ◽  
pp. 792-799 ◽  
Author(s):  
Eric A. Feldman
Keyword(s):  
Health Care ◽  
Medical Malpractice ◽  
Japanese Patients ◽  
Adverse Outcomes ◽  
Malpractice Litigation ◽  
Care Experience ◽  
Cost Of Health Care ◽  
American Legal System ◽  
The Cost ◽  
The U.S

The cost of health care, its growing share of the gross domestic product (GDP), and dire predictions about the future are a major political and economic issue in the U.S. The American legal system is commonly viewed as a significant part of the problem, particularly by those who believe that medical providers engage in defensive medicine in an effort to avoid malpractice litigation. Yet scholars and commentators in the U.S. have shown relatively little interest in how other nations manage legal conflict over health care and whether they might learn something from abroad about the relationship between malpractice litigation and the health care system more generally.To that end, this article analyzes the Japanese health care experience, specifically the management of what are variously called adverse outcomes, medical accidents, and medical malpractice. How frequently do Japanese patients sue their doctors? Are medical malpractice litigation rates in Japan rising? If so, what is being done to control the increase and its impact on medical care? How well is Japan doing when it comes to balancing the needs of patients who believe they are victims of medical negligence with those of providers who think they are being unfairly accused? These are the questions, about Japan (and elsewhere), that need to be asked by those interested in the nexus of law and health care in the U.S.

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